Thursday, March 2, 2017

Louisiana Department of Health launches Medicaid Expansion Dashboard

Author: Andrew Tuozzolo, Chief of Staff

As the Louisiana Department of Health undertook Medicaid
expansion in 2016, we focused on making the process as efficient and
transparent as possible. To demonstrate the outcomes and success of expansion,
Dr. Rebekah Gee, Secretary of the Louisiana Department of Health, challenged the
agency to build an online dashboard to present real-time data in an easy to
understand format. Taking up Dr. Gee’s charge, a team was formed that leveraged
the expertise of Medicaid leaders, data analysts, developers, and
communications staff.

The team began by reviewing the websites of other states
that had expanded Medicaid, looking to see if good examples already existed,
finding several good examples including Alaska, Kentucky and others. The group noticed that
most states that posted expansion information did so using static graphics.

Our team, inspired by Dr. Gee’s direction on innovation and
transparency, knew that we wanted to do more. Our goal was to create a
dashboard that was informative, interactive, and that could easily sync to
existing data sources. The team believed this would be of value to those who
used the website for information, and also to internal teams. As the design
team began to study existing dashboard applications, Medicaid program managers began
to define the metrics that would be presented on the site. The goals for these data
were; 1) clearly demonstrate enrollment measures, 2) define meaningful outcome
measures that were consistent with nationally accepted quality measures, 3) that
were readily accessible by internal data analysts, and 4) that could be displayed
easily and quickly without expensive programming costs or staff time.

On the technical side, Lee Mendoza, our site developer,
built the dashboard using HTML, JavaScript, and CSS, along with bootstrap for
cross-platform responsive design and jquery for ease of coding. The detailed graphs
and the state map are Highcharts.com
components.

The values displayed in each graph and the map are not
hard-coded, but instead are contained in separate csv or json files. Our
Medicaid Health Economics and Quality teams provide the data in spreadsheets. Custom
scripts are then used to parse the spreadsheets, make individual data files for
each component, and transfer the data files to our development server for
review before transferring to the public site. Because the values are not
hard-coded in the graphs, the site can be updated quickly when new data is
available. In the future, our goal is to completely automate the process.

The results of the team’s effort can be found here (for both traditional displays and mobile devices).
The enrollment data is updated weekly and can be viewed at both the state and
parish level. The outcomes measures are updated every two weeks. Each measure
is expandable, allowing users to get even more info and charts/graphs.
Additionally, clicking on or touching the map shows outcome measures at the
parish level. The data displayed in the graphs and map are available for
download from a menu on the graph or map.

Critically, LDH built this tool in-house and at no
additional taxpayer expense. Where some states hired consulting firms to
develop their dashboards (for example, Kentucky used Deloitte Consulting),
Louisiana’s team had no funding for expensive vendors or consultants, relying solely
on collaboration across the Department and our in-house, talented team members.

Today, our dashboard not only allows citizens, state
officials, news reporters and others to get Louisiana Medicaid expansion data
quickly, it is also being recognized by others. Officials from Ohio, California
and Colorado have contacted us about our site, seeking input and information to
help them develop similar sites for their states.

Andy Slavitt, former administrator of the Centers for Medicare
and Medicaid Services (CMS), has promoted our dashboard in his communications.
Gallop has included it in news stories about their poll results, and the dashboard’s
online link or URL appears in almost all news stories about Louisiana Medicaid
expansion.

From research to design to execution to results, the
dashboard that is known as the HealthyLaDashboard has fulfilled the vision of
Secretary Gee, Louisiana’s Governor, John Bel Edwards, and the agency’s
leadership. Providing transparent, easy-to-understand data helps inform
citizens, drive policy change, and help prove we are finally on the road to a
healthier Louisiana.

The Medicaid Dashboard has been an important tool in my tool-box. I use data from the dashboard daily in my communications about the impact of the ACA in LA. Not only do I have access to real-time enrollment numbers but I can also identify relevant outcomes at a more granular level.